Partially Hydrolysed Whey-Based Infant Formula Improves Skin Barrier Function

Specific partially hydrolysed whey-based infant formulas (pHF-W) have been shown to decrease the risk of atopic dermatitis (AD) in infants. Historically, AD has been associated primarily with milk allergy; however, defective skin barrier function can be a primary cause of AD. We aimed to ascertain whether oral supplementation with pHF-W can improve skin barrier function. The effect of pHF-W was assessed on transepidermal water loss (TEWL) and antibody productions in mice epicutaneously exposed to Aspergillus fumigatus. Human primary keratinocytes were stimulated in vitro, and the expression of genes related to skin barrier function was measured. Supplementation with pHF-W in neonatal mice led to a significant decrease in TEWL and total IgE, but not in allergen-specific antibody levels. The whey hydrolysate was sufficient to decrease both TEWL and total IgE. Aquaporin-3 gene expression, linked with skin hydration, was modulated in the skin of mice and human primary keratinocytes following protein hydrolysate exposure. Skin barrier improvement may be an additional mechanism by which pHF-W may potentially reduce the risk of AD development in infants. Further human studies are warranted to confirm the clinical efficacy of these observations

Genome Evolution of Two Genetically Homogeneous Infectious Bursal Disease Virus Strains During Passages in vitro and ex vivo in the Presence of a Mutagenic Nucleoside Analog

The avibirnavirus infectious bursal disease virus (IBDV) is responsible for a highly contagious and sometimes lethal disease of chickens (Gallus gallus). IBDV genetic variation is well-described for both field and live-attenuated vaccine strains, however, the dynamics and selection pressures behind this genetic evolution remain poorly documented. Here, genetically homogeneous virus stocks were generated using reverse genetics for a very virulent strain, rvv, and a vaccine-related strain, rCu-1. These viruses were serially passaged at controlled multiplicities of infection in several biological systems, including primary chickens B cells, the main cell type targeted by IBDV in vivo. Passages were also performed in the absence or presence of a strong selective pressure using the antiviral nucleoside analog 7-deaza-2′-C-methyladenosine (7DMA). Next Generation Sequencing (NGS) of viral genomes after the last passage in each biological system revealed that (i) a higher viral diversity was generated in segment A than in segment B, regardless 7DMA treatment and viral strain, (ii) diversity in segment B was increased by 7DMA treatment in both viruses, (iii) passaging of IBDV in primary chicken B cells, regardless of 7DMA treatment, did not select cell-culture adapted variants of rvv, preserving its capsid protein (VP2) properties, (iv) mutations in coding and non-coding regions of rCu-1 segment A could potentially associate to higher viral fitness, and (v) a specific selection, upon 7DMA addition, of a Thr329Ala substitution occurred in the viral polymerase VP1. The latter change, together with Ala270Thr change in VP2, proved to be associated with viral attenuation in vivo. These results identify genome sequences that are important for IBDV evolution in response to selection pressures. Such information will help tailor better strategies for controlling IBDV infection in chickens

Redefining palliative care-a new consensus-based definition

Context: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective: The main objective of this article is to present the research behind the new definition. Methods: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span

Understanding the roles of the P2X7 receptor in solid tumour progression and therapeutic perspectives

P2X7 is an intriguing ionotropic receptor for which the activation by extracellular ATP induces rapid inward cationic currents and intracellular signalling pathways associated with numerous physiological processes such as the induction of the inflammatory cascade, the survival and proliferation of cells. In contrast, long-term stimulation of P2X7 is generally associated with membrane permeabilisation and cell death. Recently, P2X7 has attracted great attention in the cancer field, and particularly in the neoplastic transformation and the progression of solid tumours. A growing number of studies were published; however they often appeared contradictory in their results and conclusions. As such, the involvement of P2X7 in the oncogenic process remains unclear so far. The present review aims to discuss the current knowledge and hypotheses on the involvement of the P2X7 receptor in the development and progression of solid tumours, and highlight the different aspects that require further clarification in order to decipher whether P2X7 could be considered as a cancer biomarker or as a target for pharmacological intervention. This article is part of a Special Issue entitled: Membrane channels and transporters in cancers

Différences de prise en charge aux urgences entre les patients adressés par un médecin libéral et les patients tout venant.

Médecine généraleLe système de santé français est réputé l’un des meilleurs au monde. Pourtant celui-ci doit faire face à l’un de ses plus grands défis. La diminution prochaine du nombre de médecins généralistes, de par leur départ à la retraite, va accroître les disparités d’accès aux soins sur l’ensemble du territoire et plusieurs patients vont se retrouver sans médecin traitant. Face à la pénurie de cet accès aux soins, de nombreuses personnes utilisent les services d’urgences comme soins de premiers recours, augmentant le nombre de passages et avec eux le nombre de patients venant pour des motifs relevant de la médecine générale. Cependant les médecins libéraux (généralistes ou non) ont parfois besoin d’adresser un patient aux Urgences en fonction du contexte clinique. Il y a donc deux types de patients se présentant aux Urgences, ceux venant spontanément et ceux adressés par un médecin. L’objectif de cette étude est de déterminer s’il existe une différence de prise en charge et de gravité chez les patients se présentant par leur propre moyen aux Urgences, en fonction du fait qu’ils soient adressés par un médecin libéral ou non. Il s’agit d’une étude rétrospective descriptive, monocentrique, réalisée dans le service des Urgences de Hautepierre, aux Hôpitaux Universitaires de Strasbourg, qui s’est déroulée sur la semaine du 13 au 19 mai 2019. Au total, 443 dossiers ont été analysés. Nous observons parmi les patients se présentant spontanément aux Urgences, adressés par un médecin, qu’ils sont plus âgés et bénéficient de plus d’examens de biologie ainsi que de plus d’examens d’imagerie. De plus, ils sont plus souvent hospitalisés que les patients non adressés. Cependant, comme notre étude est monocentrique, sur le site de l’hôpital d’Hautepierre, certains motifs de consultation n’ont pas pu être étudiés, notamment les motifs cardio-vasculaires. En conclusion, le recours aux services d’accueil des Urgences par les médecins généralistes apparaît justifié et semble être un facteur prédictif d’hospitalisation. Mais il résulte parfois d’un défaut d’organisation et d’accessibilité au réseau de soins primaires. Une étude prospective incluant de pair les dossiers des patients se présentant aux Urgences du Nouvel Hôpital Civil et d’Hautepierre pourrait être une bonne suite à donner à notre travail.The French Health Systeme is one of the best in the world. Regardless, it's facing one of it biggest challenge. The decrease nomber of general practitioner, by retirement,is gonna increase difficulties in care acces on the territory and some patients are gonna lose their GP. Facing this difficulties, some patients go to ER as primary acces care. Increasing the nomber of patients coming with problemes that could have been taken care by a GP. However liberal practitioners need to adress patients to the ER. So there is two types of patients coming to the ER, those sent by a liberal practitioner and those coming by themself. This study's purpose is to show if there is a difference of hospital care and gravity between those two groups. This study is retrospective,monocentric, taking place in the Hautepierre's ER, Strasbourg's University Hospital, during the week of may 2019 from 13 to 19. 443 have been analysed. We can observe that patients sent to ER by a liberal practitioner are older, have more biological tests ou medical imaging. They are also more lickely to be hospitalised than patients coming by themself. But our study is monocentric in Hautepierre's Hospital, some medical grounds weren't studied (like cardio vascular ones). A prospective study including all patients coming to Strsabourg's ER could be the follow-up to this work